There is considerable evidence that outcome following intervention for coronary artery disease in women may be worse than it is for men, The influence of gender on outcome following peripheral vascular surgery has received less attention and is the subject of this review. The incidence of most vascular procedures in women is 20-40% that of men. Women appear to have a greater risk of dying following surgery for abdominal aortic aneurysm, a higher risk of stroke and death following carotid endarterectomy, and poorer patency rates following infrainguinal bypass, The causes may include delayed diagnosis and referral, increased co-morbidity and possibly the effect of smaller arteries in women. (C) 2000 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd, All rights reserved.